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Ismelin and Sudafed PE Cold & Cough

Determining the interaction of Ismelin and Sudafed PE Cold & Cough and the possibility of their joint administration.

Check result:
Ismelin <> Sudafed PE Cold & Cough
Relevance: 24.08.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Using guanethidine together with phenylephrine may alter the effects of both medications. Specifically, phenylephrine can reduce the effects of guanethidine in treating high blood pressure, while its own effects may be increased or decreased. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

MONITOR: Sympathomimetic amines may decrease the hypotensive effect of postganglionic adrenergic blocking agents, while the latter may potentiate the pharmacologic effects of direct-acting sympathomimetic amines (e.g., dobutamine, epinephrine, methoxamine, norepinephrine) but inhibit those that are primarily indirect-acting (e.g., mephentermine). Postganglionic adrenergic blocking agents such as guanadrel, guanethidine, and rauwolfia alkaloids work by depleting catecholamine stores from adrenergic nerve endings. Therefore, they may sensitize adrenergic receptors to direct-acting sympathomimetics, but blunt the effects of indirect-acting agents whose activity is mediated through the release of catecholamines. Guanethidine and reserpine have been reported to attenuate the pharmacologic effects (mydriasis, pressor response) induced by ephedrine and dopamine, both of which exhibit direct and indirect sympathomimetic activities (i.e., mixed-acting). However, guanethidine intensified the mydriasis produced by phenylephrine, which is also thought to be mixed-acting. Conversely, ephedrine has been shown to partially reverse the hypotensive effect of guanethidine.

MANAGEMENT: Due to their pressor effect, sympathomimetic amines should be used cautiously in patients with hypertension. Alternatives to postganglionic adrenergic blocking agents should be considered if patients are treated with sympathomimetic amines, since effects of the latter may be intensified or diminished depending on whether they are direct- or indirect-acting. Most agents with indirect sympathomimetic activity are mixed-acting, thus it may be difficult to predict how they will be affected by postganglionic adrenergic blocking agents. If the combination is used, blood pressure and heart rate should be monitored.

References
  • Gulati OD, Dave BT, Gokhale SD, Shah KM "Antagonism of adrenergic neuron blockade in hypertensive subjects." Clin Pharmacol Ther 7 (1966): 510-4
  • Muelheims GH, Entrup RW, Paiewonsky D, Mierzwiak DS "Increased sensitivity of the heart to catecholamine-induced arrhythmias following guanethidine." Clin Pharmacol Ther 6 (1965): 757-62
  • Sherman GP, Walton CA "Adrenergic transmission and drug interaction." J Am Pharm Assoc 15 (1975): 86-90
  • Sneddon JM, Turner P "Ephedrine mydriasis in hypertension and the response to treatment." Clin Pharmacol Ther 10 (1969): 64-71
  • Ziegler CH, Lovette JB "Operative complications after therapy with reserpine and reserpine compounds." JAMA 176 (1961): 114-7
  • Spiers AS, Calne DB "Action of dopamine on the human iris." Br Med J 4 (1969): 333-5
  • Burn JH, Rand MJ "The action of sympathomimetic amines in animals treated with reserpine." J Physiol (Lond) 144 (1958): 314-36
  • Hardman JG, Gilman AG, Limbird LE eds. "Goodman and Gilman's the Pharmacological Basis of Therapeutics. 9th ed." New York, NY: McGraw-Hill (1995):
Ismelin

Generic Name: guanethidine

Brand name:

Synonyms: Ismelin (Oral)

Sudafed PE Cold & Cough

Generic Name: acetaminophen / dextromethorphan / guaifenesin / phenylephrine

Brand name: DayQuil Severe Cold & Flu, Delsym Cough Plus Cold Day Time, Mucinex Children's Cold, Cough & Sore Throat, Mucinex Fast-Max Severe Cold, Sudafed PE Cold & Cough, Tylenol Cold & Flu Severe, Tylenol Cold Multi-Symptom Severe, Mucinex Sinus-Max, Sudafed PE Cold/Cough, Tylenol Cold Head Congestion, Tylenol Cold Multi Symptom, Tylenol Cold/Flu Severe, Vicks DayQuil Severe Cold/Flu

Synonyms: n.a.

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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